Comparison of neuromuscular adjustments associated with sustained isometric contractions of four different muscle groups

Muscle Strength Preservation During Repeated Sets of Fatiguing Resistance Exercise: A Secondary Analysis

ABSTRACT

Nuzzo, JL. Muscle strength preservation during repeated sets of fatiguing resistance exercise: A secondary analysis. J Strength Cond Res 38(6): 1149-1156, 2024-During sustained or repeated maximal voluntary efforts, muscle fatigue (acute strength loss) is not linear. After a large initial decrease, muscle strength plateaus at approximately 40% of baseline. This plateau, which likely reflects muscle strength preservation, has been observed in sustained maximal isometric and repeated maximal isokinetic contractions. Whether this pattern of fatigue occurs with traditional resistance exercise repetitions with free weights and weight stack machines has not been overviewed. Here, the aim was to determine whether the number of repetitions completed across 4 or more consecutive repetitions-to-failure tests exhibits the same nonlinear pattern of muscle fatigue. A secondary analysis was applied to data extracted as part of a recent meta-analysis on repetitions-to-failure tests. Studies were eligible if they reported mean number of repetitions completed in 4-6 consecutive repetitions-to-failure tests at a given relative load. Twenty-nine studies were included. Overall, the results show that the number of repetitions completed in consecutive repetitions-to-failure tests at a given load generally decreases curvilinearly. The numbers of repetitions completed in sets 2, 3, 4, 5, and 6 were equal to approximately 70, 55, 50, 45, and 45% of the number of repetitions completed in set 1, respectively. Longer interset rest intervals typically attenuated repetition loss, but the curvilinear pattern remained. From the results, a chart was created to predict the number of repetitions across 6 sets of resistance exercise taken to failure based on the number of repetitions completed in set 1. The chart is a general guide and educational tool. It should be used cautiously. More data from a variety of exercises, relative loads, and interset rest intervals are needed for more precise estimates of number of repetitions completed during repeated sets of fatiguing resistance exercise.

Corticospinal and spinal responses following a single session of lower limb motor skill and resistance training

Prior studies suggest resistance exercise as a potential form of motor learning due to task-specific corticospinal responses observed in single sessions of motor skill and resistance training. While existing literature primarily focuses on upper limb muscles, revealing a task-dependent nature in eliciting corticospinal responses, our aim was to investigate such responses after a single session of lower limb motor skill and resistance training. Twelve participants engaged in a visuomotor force tracking task, self-paced knee extensions, and a control task. Corticospinal, spinal, and neuromuscular responses were measured using transcranial magnetic stimulation (TMS) and peripheral nerve stimulation (PNS). Assessments occurred at baseline, immediately post, and at 30-min intervals over two hours. Force steadiness significantly improved in the visuomotor task (P < 0.001). Significant fixed-effects emerged between conditions for corticospinal excitability, corticospinal inhibition, and spinal excitability (all P < 0.001). Lower limb motor skill training resulted in a greater corticospinal excitability compared to resistance training (mean difference [MD] = 35%, P < 0.001) and control (MD; 37%, P < 0.001). Motor skill training resulted in a lower corticospinal inhibition compared to control (MD; - 10%, P < 0.001) and resistance training (MD; - 9%, P < 0.001). Spinal excitability was lower following motor skill training compared to control (MD; - 28%, P < 0.001). No significant fixed effect of Time or Time*Condition interactions were observed. Our findings highlight task-dependent corticospinal responses in lower limb motor skill training, offering insights for neurorehabilitation program design.

Effects of a Sustained, Isometric Forearm Flexion Task to Failure on Torque and Neuromuscular Responses at 3 Elbow Joint Angles

ABSTRACT

Ortega, DG, Housh, TJ, Smith, RW, Arnett, JE, Neltner, TJ, Anders, JPV, Schmidt, RJ, and Johnson, GO. The effects of a sustained, isometric forearm flexion task to failure on torque and neuromuscular responses at 3 elbow joint angles. J Strength Cond Res 38(1): e25-e33, 2024-This study examined the effects of a sustained, isometric forearm flexion task anchored to torque to task failure on maximal voluntary isometric contraction (MVIC) and neuromuscular responses at 3 elbow joint angles. Eleven women (mean ± SD: age = 20.8 ± 2.7 years, height = 169.3 ± 7.4 cm, body mass = 67.7 ± 6.9 kg) performed two 3s forearm flexion MVICs at elbow joint angles (JAs) of 75°, 100°, and 125° before and after a sustained, isometric forearm flexion task to failure at a fatiguing joint angle of 100° anchored to a torque value that corresponded to a rating of perceived exertion of 8 (RPE = 8). The amplitude (AMP) and mean power frequency (MPF) of the electromyographic (EMG) and mechanomyographic (MMG) signals were recorded from the biceps brachii. Repeated-measures ANOVAs were used to compare mean differences for MVIC and neuromuscular parameters. Collapsed across JAs, MVIC (p < 0.001) and EMG MPF (p = 0.006) pretest values were greater than posttest values. Collapsed across time, EMG MPF at JA75 was greater than JA100 (p < 0.001) and JA125 (p < 0.001), and JA100 was greater (p = 0.007) than JA125. For EMG AMP, there was a fatigue-induced decrease at JA75 (p = 0.003). For neuromuscular efficiency (NME = normalized torque/normalized EMG AMP), there were decreases from pretest to posttest at JA100 (p = 0.002) and JA125 (p = 0.008). There were no significant interactions or main effects for MMG AMP and MMG MPF. From these findings, it was hypothesized that the decline in MVICs at JA75, JA100, and JA125 was due to fatigue-induced metabolic perturbations that resulted in JA-specific neuromuscular responses. Thus, neuromuscular parameters may provide insight into the JA-specific mechanisms of fatigue.

Characterization of neuromuscular performances in adults with late-onset Pompe disease: A control case cross-sectional study

Adults with late-onset Pompe disease (aLOPD) are characterized by muscular contractile tissue deterioration. However, their neuromuscular performances are poorly known. We aimed to compare maximal muscle strength, activation, explosive strength and neuromuscular fatigue between aLOPD and controls. We studied 20 aLOPD and 20 matched controls. Isometric maximum voluntary contraction (MVC) torque was obtained for the hip, knee and ankle muscles. The voluntary activation level (VAL) during knee extensor MVC was assessed using interpolated twitch technique. Explosive strength was evaluated for knee and ankle muscles through the rate of torque development (RTD) during fast contractions. Neuromuscular fatigue was measured during a 30-second contraction of knee flexors and extensors. All muscle MVC torques were significantly lower in aLOPD than controls (p <0.05). The weakest muscles were the hip extensors followed by hip abductors and abductors. Raw value of RTD was lower in aLOPD for the majority of muscles (p <0.05). No intergroup differences were reported for normalized RTD, VAL and neuromuscular fatigue (p-values> 0.05). Our study shows that maximal strength was the only neuromuscular characteristic affected in aLOPD with a proximal-distal intensity gradient. This suggests that the surviving muscle tissue of aLOPD is as functionally efficient as that of control individuals.

M-wave changes caused by brief voluntary and stimulated isometric contractions

INTRODUCTION

Under isometric conditions, the increase in muscle force is accompanied by a reduction in the fibers' length. The effects of muscle shortening on the compound muscle action potential (M wave) have so far been investigated only by computer simulation. This study was undertaken to assess experimentally the M-wave changes caused by brief voluntary and stimulated isometric contractions.

METHODS

Two different methods of inducing muscle shortening under isometric condition were adopted: (1) applying a brief (1 s) tetanic contraction and (2) performing brief voluntary contractions of different intensities. In both methods, supramaximal stimulation was applied to the brachial plexus and femoral nerves to evoke M waves. In the first method, electrical stimulation (20 Hz) was delivered with the muscle at rest, whereas in the second, stimulation was applied while participants performed 5-s stepwise isometric contractions at 10, 20, 30, 40, 50, 60, 70, and 100% MVC. The amplitude and duration of the first and second M-wave phases were computed.

RESULTS

The main findings were: (1) on application of tetanic stimulation, the amplitude of the M-wave first phase decreased (~ 10%, P < 0.05), that of the second phase increased (~ 50%, P < 0.05), and the M-wave duration decreased (~ 20%, P < 0.05) across the first five M waves of the tetanic train and then plateaued for the subsequent responses; (2) when superimposing a single electrical stimulus on muscle contractions of increasing forces, the amplitude of the M-wave first phase decreased (~ 20%, P < 0.05), that of the second phase increased (~ 30%, P < 0.05), and M-wave duration decreased (~ 30%, P < 0.05) as force was raised from 0 to 60-70% MVC force.

CONCLUSIONS

The present results will help to identify the adjustments in the M-wave profile caused by muscle shortening and also contribute to differentiate these adjustments from those caused by muscle fatigue and/or changes in Na+-K+ pump activity.

Corticospinal and spinal adaptations following lower limb motor skill training: a meta-analysis with best evidence synthesis

Motor skill training alters the human nervous system; however, lower limb motor tasks have been less researched compared to upper limb tasks. This meta-analysis with best evidence synthesis aimed to determine the cortical and subcortical responses that occur following lower limb motor skill training, and whether these responses are accompanied by improvements in motor performance. Following a literature search that adhered to the PRISMA guidelines, data were extracted and analysed from six studies (n = 172) for the meta-analysis, and 11 studies (n = 257) were assessed for the best evidence synthesis. Pooled data indicated that lower limb motor skill training increased motor performance, with a standardised mean difference (SMD) of 1.09 being observed. However, lower limb motor skill training had no effect on corticospinal excitability (CSE), Hoffmann's reflex (H-reflex) or muscle compound action potential (M_MAX) amplitude. The best evidence synthesis found strong evidence for improved motor performance and reduced short-interval cortical inhibition (SICI) following lower limb motor skill training, with conflicting evidence towards the modulation of CSE. Taken together, this review highlights the need for further investigation on how motor skill training performed with the lower limb musculature can modulate corticospinal responses. This will also help us to better understand whether these neuronal measures are underpinning mechanisms that support an improvement in motor performance.

Effects of Different Isometric Training Programs on Muscle Size and Function in the Elbow Flexors

It remains unknown whether a regimen of a combination of high- and low-intensity resistance training increases muscle size and maximal voluntary isometric contraction (MVC) simultaneously. This study aimed to clarify the effect of the combination of high- and low-intensity resistance training on muscle size and neuromuscular function in the elbow flexors. Sixteen male adults participated in a 9-week isometric training regimen in elbow joint flexion of each arm. We randomly assigned two different training regimens to left and right arms: one aiming to strengthen maximal strength (ST) and the other aiming to develop muscle size as well as maximal strength, which consists of one contraction to volitional failure with 50% of MVC added to ST (COMB). Following the 3-week training to volitional failure as familiarization, the participants conducted the 6-week ST and COMB training in each arm. Before the intervention, and at the third (Mid) and ninth (Post) weeks, MVC and muscle thickness in the anterior part of the upper arm (ultrasound) were measured. Muscle cross-sectional area (mCSA) was derived from the obtained muscle thickness. From Mid to Post, the relative change in MVC was similar in both arms. The COMB regimen increased muscle size, but no significant change was found in ST. Following the 3-week isometric training to volitional failure, the 6-week training regimen for developing maximal voluntary and muscle hypertrophy increased MVC, with increasing mCSA, and the training-induced change in MVC was similar to that for developing maximal voluntary strength alone.

Comparisons in muscle compound action potential parameters measured during standing, walking, and running

The muscle compound action potential (M-wave) has been used as an indicator of peripheral muscle conditions during rest or on isometric muscle contraction. The present study aimed to compare the M-wave parameters during standing, walking, and running. Seventeen young males performed four sets of repeated maximal isometric plantar flexion. Before, after, and between the repeated contraction tasks, M-waves in the soleus muscle were measured during standing, walking, and running. M-waves on walking and running were elicited at the beginning of the swing phase when the soleus muscle was not voluntarily activated. From the detected M-waves, the amplitude, area, and latency for first and second phases were calculated. Amplitudes for first and second phases were not significantly different between standing and walking/running. The area and latency for both phases during walking/running were significantly lower than those during standing (p < 0.05). Significant correlations in amplitude and area were found between standing and walking/running for the first phase (p < 0.05), but not for the second phase (p > 0.05). These results suggest that assessments of the M-wave amplitude for the first phase can be applied to walking and running in the same way as for standing in the soleus muscle.

Performance fatigability and recovery after dynamic multi-joint maximal exercise in elbow flexors versus knee extensors

Elbow flexors (EF) and knee extensors (KE) have shown differences in performance fatigability and recovery of neuromuscular function after isometric and isotonic single-joint fatiguing contractions. However, dynamic multi-joint movements are more representative of real-world activities. The aim of the study was to assess central and peripheral mechanisms of fatigability after either arm-cranking or cycling. Ten physically-active men performed maximal incremental arm-cranking and cycling until task-failure. Maximal voluntary isometric contraction (MVIC) and electrically-evoked forces of both EF and KE were assessed before (PRE) and 1 (POST) and 20 (POST20) min after exercise. At POST, MVIC decreased similarly to 76 ± 8% and 81 ± 7% (both P < 0.001) of PRE for EF and KE, respectively. MVIC force remained lower than PRE at POST20 for both EF and KE (85 ± 8% vs. 95 ± 3% of PRE, P ≤ 0.033), having recovered less in EF than KE (P = 0.003). Electrically-evoked forces decreased similarly from PRE to POST in EF and KE (all P > 0.05). At POST20, the ratio of low-to-high frequency doublets was lowerin EF than KE (75 ± 13% vs. 85 ± 10% of PRE; P ≤ 0.034). Dynamic maximal incremental exercise acutely induced similar magnitudes of MVIC and evoked forces loss in EF and KE. However, at POST20, impaired MVIC recovery and lower ratio of low-to-high frequency doublets in EF compared to KE suggests the recovery of neuromuscular function after dynamic maximal exercises is specific to and dependent on changes within the muscles investigated.

Creatine supplementation attenuates the rate of fatigue development during intermittent isometric exercise performed above end-test torque

NEW FINDINGS

What is the central question of this study? Does creatine supplementation augment the total torque impulse accumulated above end-test torque (IET) during severe-intensity knee-extensor exercise by attenuating the rate of decrease in peak potentiated twitch torque (PT)? What is the main finding and its importance? Creatine augmented the IET and attenuated the rate of decrease in both voluntary activation and PT during severe-intensity exercise. The IET was related to the rate of decrease in PT. These findings reveal an important role for the rates of neuromuscular fatigue development as key determinants of exercise tolerance within the severe domain.

ABSTRACT

This study investigated the effect of creatine supplementation on exercise tolerance, total torque impulse accumulated above end-test torque (total IET) and neuromuscular fatigue development of the knee extensors during severe-intensity intermittent isometric exercise. Sixteen men were randomly allocated into Creatine (n = 8, 20 g day^-1 for 5 days) or Placebo (n = 8) groups and performed knee-extensor maximal voluntary contraction (MVC) testing, all-out testing to determine end-test torque (ET) and the finite torque impulse accumulated above end-test torque (IET'), and three submaximal tests at ET + 10%: (i) time to task failure without supplementation (Baseline); (ii) time to task failure after creatine or placebo supplementation; and (iii) time matched to Baseline after creatine (Creatine-Isotime) or placebo (Placebo-Isotime) supplementation. Creatine supplementation significantly increased the time to task failure (Baseline = 572 ± 144 s versus Creatine = 833 ± 221 s) and total IET (Baseline = 5761 ± 1710  N m s versus Creatine = 7878 ± 1903 N m s), but there were no significant differences within the Placebo group. The percentage change pre- to postexercise in MVC, voluntary activation, peak potentiated twitch torque and integrated EMG during MVC were not significantly different between Baseline and Creatine but were all significantly attenuated in Creatine-Isotime compared with Baseline. There were no significant differences in these variables within the placebo group. The total IET was significantly correlated with the rates of change in potentiated twitch torque peak (r = 0.83-0.87) and rate of torque development (r = -0.83 to -0.87) for the submaximal tests to task failure. These findings reveal an important role for the rates of neuromuscular fatigue development as key determinants of exercise tolerance during severe-intensity intermittent isometric exercise.

Is there an intermuscular relationship in voluntary activation capacities and contractile kinetics?

PURPOSE

The force-generating capacities of human skeletal muscles are interrelated, highlighting a common construct of limb strength. This study aimed to further determine whether there is an intermuscular relationship in maximal voluntary activation capacities and contractile kinetics of human muscles.

METHODS

Twenty-six young healthy individuals participated in this study. Isometric maximal voluntary contraction (MVC) torque, voluntary activation level (VAL), and doublet twitch contractile kinetics (contraction time and half-relaxation time) evoked by a paired supramaximal peripheral nerve stimulation at 100 Hz were obtained in elbow flexors, knee extensors, plantar flexors and dorsiflexors of the dominant limb.

RESULTS

Peak MVC torque had significant positive correlations between all muscle group pairs (all P values < 0.01). A significant positive correlation for VAL was found only between knee extensors and plantar flexors (r = 0.60, P < 0.01). There were no significant correlations between all muscle group pairs for doublet twitch contraction time and doublet twitch half-relaxation time.

DISCUSSION

These results show that there is a partial common construct of maximal voluntary activation capacities that only concerns muscle groups that have incomplete activation during MVC (i.e., knee extensors and plantar flexors). This suggests that the common construct of MVC strength between these two muscle groups is partly influenced by neural mechanisms. The lack of intermuscular relationship of contractile kinetics showed that there is no common construct of muscle contractile kinetics, as assessed in vivo by investigating the time-course of evoked doublet twitch contractions.

The short-term recovery of corticomotor responses in elbow flexors

Background

The recovery of neurophysiological parameters at various time intervals following fatiguing exercise has been investigated previously. However, the repetition of neuromuscular assessments during the recovery period may have interfered with the true corticomotor excitability responses. In this experiment, fatiguing contractions were combined with a single post-fatigue assessment at varying time points. Ten participants undertook 5 bouts of 60-s maximal voluntary contractions (MVC) of the elbow flexors, separated by 20 min. Before and after each 60-s fatiguing exercise (FAT), participants performed a series of 6-s contractions at 100, 75 and 50% of their MVC during which transcranial magnetic, transmastoid electrical and brachial plexus electrical stimuli were used to elicit motor evoked potentials (MEP), cervicomedullary motor evoked potentials (CMEP) and compound muscle action potentials (Mmax) in the biceps brachii muscle, respectively. Post-FAT measurements were randomly performed 0, 15, 30, 60, or 120 s after each FAT.

Results

MVC force declined to 65.1 ± 13.1% of baseline following FAT and then recovered to 82.7 ± 10.2% after 60 s. The MEP·Mmax⁻¹ ratio recorded at MVC increased to 151.1 ± 45.8% and then returned to baseline within 60 s. The supraspinal excitability (MEP·CMEP⁻¹) measured at MVC increased to 198.2 ± 47.2% and fully recovered after 30 s. The duration of post-MEP silent period recorded at MVC elongated by 23.4 ± 10.6% during FAT (all P < 0.05) but fully recovered after 15 s.

Conclusions

The current study represents the first accurate description of the time course and pattern of recovery for supraspinal and spinal excitability and inhibition following a short maximal fatiguing exercise in upper limb.

The role of the nervous system in neuromuscular fatigue induced by ultra-endurance exercise

Ultra-endurance events are not a recent development but they have only become very popular in the last 2 decades, particularly ultramarathons run on trails. The present paper reviews the role of the central nervous system in neuromuscular fatigue induced by ultra-endurance exercise. Large decreases in voluntary activation are systematically found in ultra-endurance running but are attenuated in ultra-endurance cycling for comparable intensity and duration. This indirectly suggests that afferent feedback, rather than neurobiological changes within the central nervous system, is determinant in the amount of central fatigue produced. Whether this is due to inhibition from type III and IV afferent fibres induced by inflammation, disfacilitation of Ia afferent fibers owing to repeated muscle stretching or other mechanisms still needs to be determined. Sleep deprivation per se does not seem to play a significant role in central fatigue although it still affects performance by elevating ratings of perceived exertion. The kinetics of central fatigue and recovery, the influence of muscle group (knee extensors vs plantar flexors) on central deficit as well as the limitations related to studies on central fatigue in ultra-endurance exercise are also discussed in the present article. To date, no study has quantified the contribution of spinal modulations to central fatigue in ultra-endurance events. Future investigations utilizing spinal stimulation (i.e., thoracic stimulation) must be conducted to assess the role of changes in motoneuronal excitability on the observed central fatigue. Recovery after ultra-endurance events and the effect of sex on neuromuscular fatigue must also be studied further.

Child-adult differences in neuromuscular fatigue are muscle-dependent

The aim of this study was to compare the development and etiology of neuromuscular fatigue of the knee extensor (KE) and plantar flexor (PF) muscles during repeated maximal voluntary isometric contractions (MVIC) between children and adults. Twenty-one prepubertal boys (9-11 years) and 24 men (18-30 years) performed two fatigue protocols consisting in a repetition of 5-s isometric MVIC of the KE or PF muscles interspersed with 5-s passive recovery periods until MVIC reached 60% of its initial value. The etiology of neuromuscular fatigue of the KE and PF muscles was investigated by means of non-invasive methods such as the surface electromyography, single and doublet magnetic stimulation, twitch interpolation technique and NIRS. The number of repetitions performed was significantly lower in men (15.4 ± 3.8) than boys (38.7 ± 18.8) for the KE fatigue test. In contrast, no significant difference was found for the PF muscles between boys and men (12.1 ± 4.9 and 13.8 ± 4.9 repetitions, respectively). Boys displayed a lower reduction in potentiated twitch torque, low-frequency fatigue and muscle oxygenation than men whatever the muscle group considered. In contrast, voluntary activation level and normalized EMG data decreased to a greater extent in boys than men for both muscle groups. To conclude, boys experienced less peripheral and more central fatigue during repeated MVICs than men whatever the muscle group considered. However, child-adult differences in neuromuscular fatigue were muscle-dependent since boys fatigued similarly to men with the PF muscles and to a lower extent with the KE muscles than men.

Effect of hypnotic suggestion on knee extensor neuromuscular properties in resting and fatigued states

Purpose

The aim of this study was to investigate whether hypnotic suggestions can alter knee extensor neuromuscular function at rest and during exercise.

Methods

Thirteen healthy volunteers (8 men and 5 women, 27 ± 3 years old) took part in this counterbalanced, crossover study including two experimental (hypnosis and control) sessions. Knee extensor neuromuscular function was tested before and after hypnosis suggestion by using a combination of voluntary contraction, transcutaneous femoral nerve electrical stimulation and transcranial magnetic stimulation (TMS). A fatiguing exercise (sustained submaximal contraction at 20% maximal voluntary contraction (MVC) force) was also performed to evaluate the potential influence of hypnosis on the extent and origin of neuromuscular adjustments.

Results

Hypnosis did not (p>0.05) alter MVC force or knee extensor neural properties. Corticospinal excitability, assessed with the amplitude of knee extensor motor evoked potentials, was also unchanged (p>0.05), as was the level of intracortical inhibition assessed with paired pulse TMS (short-interval intracortical inhibition, SICI). Time to task failure (~300 s) was not different (p>0.05) between the two sessions; accordingly, hypnosis did not influence neuromuscular adjustments measured during exercise and at task failure (p>0.05).

Conclusion

Hypnotic suggestions did not alter neuromuscular properties of the knee extensor muscles under resting condition or during/after exercise, suggesting that hypnosis-induced improvement in exercise performance and enhanced corticospinal excitability might be limited to highly susceptible participants.

Central activation, metabolites, and calcium handling during fatigue with repeated maximal isometric contractions in human muscle

PURPOSE

To determine the roles of calcium (Ca²⁺) handling by sarcoplasmic reticulum (SR) and central activation impairment (i.e., central fatigue) during fatigue with repeated maximal voluntary isometric contractions (MVC) in human muscles.

METHODS

Contractile performance was assessed during 3 min of repeated MVCs (7-s contraction, 3-s rest, n = 17). In ten participants, in vitro SR Ca²⁺-handling, metabolites, and fibre-type composition were quantified in biopsy samples from quadriceps muscle, along with plasma venous [K⁺]. In 11 participants, central fatigue was compared using tetanic stimulation superimposed on MVC in quadriceps and adductor pollicis muscles.

RESULTS

The decline of peak MVC force with fatigue was similar for both muscles. Fatigue resistance correlated directly with % type I fibre area in quadriceps (r = 0.77, P = 0.009). The maximal rate of ryanodine-induced Ca²⁺-release and Ca²⁺-uptake fell by 31 ± 26 and 28 ± 13%, respectively. The tetanic force depression was correlated with the combined reduction of ATP and PCr, and increase of lactate (r = 0.77, P = 0.009). Plasma venous [K⁺] increased from 4.0 ± 0.3 to 5.4 ± 0.8 mM over 1-3-min exercise. Central fatigue occurred during the early contractions in the quadriceps in 7 out of 17 participants (central activation ratio fell from 0.98 ± 0.05 to 0.86 ± 0.11 at 1 min), but dwindled at exercise cessation. Central fatigue was seldom apparent in adductor pollicis.

CONCLUSIONS

Fatigue with repeated MVC in human limb muscles mainly involves peripheral aspects which include impaired SR Ca²⁺-handling and we speculate that anaerobic metabolite changes are involved. A faster early force loss in quadriceps muscle with some participants is attributed to central fatigue.

Plantar flexor muscle weakness and fatigue in spastic cerebral palsy patients

BACKGROUND

Patients with cerebral palsy develop an important muscle weakness which might affect the aetiology and extent of exercise-induced neuromuscular fatigue.

AIM

This study evaluated the aetiology and extent of plantar flexor neuromuscular fatigue in patients with cerebral palsy.

METHODS

Ten patients with cerebral palsy and 10 age- and sex-matched healthy individuals (∼20 years old, 6 females) performed four 30-s maximal isometric plantar flexions interspaced by a resting period of 2-3s to elicit a resting twitch. Maximal voluntary contraction force, voluntary activation level and peak twitch were quantified before and immediately after the fatiguing task.

RESULTS

Before fatigue, patients with cerebral palsy were weaker than healthy individuals (341±134N vs. 858±151N, p<0.05) and presented lower voluntary activation (73±19% vs. 90±9%, p<0.05) and peak twitch (100±28N vs. 199±33N, p<0.05). Maximal voluntary contraction force was not significantly reduced in patients with cerebral palsy following the fatiguing task (-10±23%, p>0.05), whereas it decreased by 30±12% (p<0.05) in healthy individuals.

CONCLUSIONS

Plantar flexor muscles of patients with cerebral palsy were weaker than their healthy peers but showed greater fatigue resistance.

WHAT THIS PAPER ADDS

Cerebral palsy is a widely defined pathology that is known to result in muscle weakness. The extent and origin of muscle weakness were the topic of several previous investigations; however some discrepant results were reported in the literature regarding how it might affect the development of exercise-induced neuromuscular fatigue. Importantly, most of the studies interested in the assessment of fatigue in patients with cerebral palsy did so with general questionnaires and reported increased levels of fatigue. Yet, exercise-induced neuromuscular fatigue was quantified in just a few studies and it was found that young patients with cerebral palsy might be more fatigue resistant that their peers. Thus, it appears that (i) conflicting results exist regarding objectively-evaluated fatigue in patients with cerebral palsy and (ii) the mechanisms underlying this muscle fatigue - in comparison to those of healthy peers - remain poorly understood. The present study adds important knowledge to the field as it shows that when young adults with cerebral palsy perform sustained maximal isometric plantar flexions, they appear less fatigable than healthy peers. This difference can be ascribed to a better preservation of the neural drive to the muscle. We suggest that the inability to drive their muscles maximally accounts for the lower extent of exercise-induced neuromuscular fatigue in patients with cerebral palsy.

Time Course of Changes in Neuromuscular Parameters During Sustained Isometric Muscle Actions

Smith, CM, Housh, TJ, Herda, TJ, Zuniga, JM, Camic, CL, Bergstrom, HC, Smith, DB, Weir, JP, Hill, EC, Cochrane, KC, Jenkins, NDM, Schmidt, RJ, and Johnson, GO. Time course of changes in neuromuscular parameters during sustained isometric muscle actions. J Strength Cond Res 30(10): 2697-2702, 2016-The objective of the present study was to identify the time course of changes in electromyographic (EMG) and mechanomyographic (MMG) time and frequency domain parameters during a sustained isometric muscle action of the leg extensors at 50% maximal voluntary isometric contraction. The EMG and MMG signals were measured from the vastus lateralis of 11 subjects to identify when motor unit activation strategies changed throughout the sustained isometric muscle action. The EMG amplitude (muscle activation) had a positive linear relationship (p = 0.018, r = 0.77) that began to increase at the initiation of the muscle action and continued until task failure. Electromyographic frequency (motor unit action potential conduction velocity) and MMG frequency (global motor unit firing rate) had negative quadratic relationships (p = 0.002, R = 0.99; p = 0.015, R = 0.94) that began to decrease at 30% of the time to exhaustion. The MMG amplitude (motor unit activation) had a cubic relationship (p = 0.001, R = 0.94) that increased from 10 to 30% of the time to exhaustion, then decreased from 40 to 70% of the time to exhaustion, and then markedly increased from 70% to task failure. The time course of changes in the neuromuscular parameters suggested that motor unit activation strategies changed at approximately 30 and 70% of the time to exhaustion during the sustained isometric muscle action. These findings indicate that the time course of changes in neuromuscular responses provide insight into the strategies used to delay the effects of fatigue and are valuable tools for quantifying changes in the fatiguing process during training programs or supplementation research.

Are There Critical Fatigue Thresholds? Aggregated vs. Individual Data

The mechanisms underlying task failure from fatiguing physical efforts have been the focus of many studies without reaching consensus. An attractive but debated model explains effort termination with a critical peripheral fatigue threshold. Upon reaching this threshold, feedback from sensory afferents would trigger task disengagement from open-ended tasks or a reduction of exercise intensity of closed-ended tasks. Alternatively, the extant literature also appears compatible with a more global critical threshold of loss of maximal voluntary contraction force. Indeed, maximal voluntary contraction force loss from fatiguing exercise realized at a given intensity appears rather consistent between different studies. However, when looking at individual data, the similar maximal force losses observed between different tasks performed at similar intensities might just be an “artifact” of data aggregation. It would then seem possible that such a difference observed between individual and aggregated data also applies to other models previously proposed to explain task failure from fatiguing physical efforts. We therefore suggest that one should be cautious when trying to infer models that try to explain individual behavior from aggregated data.

Influence of timing variability between motor unit potentials on M-wave characteristics

The transient enlargement of the compound muscle action potential (M wave) after a conditioning contraction is referred to as potentiation. It has been recently shown that the potentiation of the first and second phases of a monopolar M wave differed drastically; namely, the first phase remained largely unchanged, whereas the second phase underwent a marked enlargement and shortening. This dissimilar potentiation of the first and second phases has been suggested to be attributed to a transient increase in conduction velocity after the contraction. Here, we present a series of simulations to test if changes in the timing variability between motor unit potentials (MUPs) can be responsible for the unequal potentiation (and shortening) of the first and the second M-wave phases. We found that an increase in the mean motor unit conduction velocity resulted in a marked enlargement and narrowing of both the first and second M-wave phases. The enlargement of the first phase caused by a global increase in motor unit conduction velocities was apparent even for the electrode located over the innervation zone and became more pronounced with increasing distance to the innervation zone, whereas the potentiation of the second phase was largely independent of electrode position. Our simulations indicate that it is unlikely that an increase in motor unit conduction velocities (accompanied or not by changes in their distribution) could account for the experimental observation that only the second phase of a monopolar M wave, but not the first, is enlarged after a brief contraction. However, the combination of an increase in the motor unit conduction velocities and a spreading of the motor unit activation times could potentially explain the asymmetric potentiation of the M-wave phases.

Muscle Fatigue Affects the Interpolated Twitch Technique When Assessed Using Electrically-Induced Contractions in Human and Rat Muscles

The interpolated twitch technique (ITT) is the gold standard to assess voluntary activation and central fatigue. Yet, its validity has been questioned. Here we studied how peripheral fatigue can affect the ITT. Repeated contractions at submaximal frequencies were produced by supramaximal electrical stimulations of the human adductor pollicis muscle in vivo and of isolated rat soleus fiber bundles; an extra stimulation pulse was given during contractions to induce a superimposed twitch. Human muscles fatigued by repeated 30-Hz stimulation trains (3 s on–1 s off) showed an ~80% reduction in the superimposed twitch force accompanied by a severely reduced EMG response (M-wave amplitude), which implies action potential failure. Subsequent experiments combined a less intense stimulation protocol (1.5 s on–3 s off) with ischemia to cause muscle fatigue, but which preserved M-wave amplitude. However, the superimposed twitch force still decreased markedly more than the potentiated twitch force; with ITT this would reflect increased “voluntary activation.” In contrast, the superimposed twitch force was relatively spared when a similar protocol was performed in rat soleus bundles. Force relaxation was slowed by >150% in fatigued human muscles, whereas it was unchanged in rat soleus bundles. Accordingly, results similar to those in the human muscle were obtained when relaxation was slowed by cooling the rat soleus muscles. In conclusion, our data demonstrate that muscle fatigue can confound the quantification of central fatigue using the ITT.

Localized Electrical Impedance Myography of the Biceps Brachii Muscle during Different Levels of Isometric Contraction and Fatigue

This study assessed changes in electrical impedance myography (EIM) at different levels of isometric muscle contraction as well as during exhaustive exercise at 60% maximum voluntary contraction (MVC) until task failure. The EIM was performed on the biceps brachii muscle of 19 healthy subjects. The results showed that there was a significant difference between the muscle resistance (R) measured during the isometric contraction and when the muscle was completely relaxed. Post hoc analysis shows that the resistance increased at higher contractions (both 60% MVC and MVC), however, there were no significant changes in muscle reactance (X) during the isometric contractions. The resistance also changed during different stages of the fatigue task and there were significant decreases from the beginning of the contraction to task failure as well as between task failure and post fatigue rest. Although our results demonstrated an increase in resistance during isometric contraction, the changes were within 10% of the baseline value. These changes might be related to the modest alterations in muscle architecture during a contraction. The decrease in resistance seen with muscle fatigue may be explained by an accumulation of metabolites in the muscle tissue.

Arm-cycling sprints induce neuromuscular fatigue of the elbow flexors and alter corticospinal excitability of the biceps brachii

We examined the effects of arm-cycling sprints on maximal voluntary elbow flexion and corticospinal excitability of the biceps brachii. Recreationally trained athletes performed ten 10-s arm-cycling sprints interspersed with 150 s of rest in 2 separate experiments. In experiment A (n = 12), maximal voluntary contraction (MVC) force of the elbow flexors was measured at pre-sprint 1, post-sprint 5, and post-sprint 10. Participants received electrical motor point stimulation during and following the elbow flexor MVCs to estimate voluntary activation (VA). In experiment B (n = 7 participants from experiment A), supraspinal and spinal excitability of the biceps brachii were measured via transcranial magnetic and transmastoid electrical stimulation that produced motor evoked potentials (MEPs) and cervicomedullary motor evoked potentials (CMEPs), respectively, during a 5% isometric MVC at pre-sprint 1, post-sprint 1, post-sprint 5, and post-sprint 10. In experiment A, mean power output, MVC force, potentiated twitch force, and VA decreased 13.1% (p < 0.001), 8.7% (p = 0.036), 27.6% (p = 0.003), and 5.6% (p = 0.037), respectively, from pre-sprint 1 to post-sprint 10. In experiment B, (i) MEPs decreased 42.1% (p = 0.002) from pre-sprint 1 to post-sprint 5 and increased 40.1% (p = 0.038) from post-sprint 5 to post-sprint 10 and (ii) CMEPs increased 28.5% (p = 0.045) from post-sprint 1 to post-sprint 10. Overall, arm-cycling sprints caused neuromuscular fatigue of the elbow flexors, which corresponded with decreased supraspinal and increased spinal excitability of the biceps brachii. The different post-sprint effects on supraspinal and spinal excitability may illustrate an inhibitory effect on supraspinal drive that reduces motor output and, therefore, decreases arm-cycling sprint performance.

Plantar flexor neuromuscular adjustments following match-play football in hot and cool conditions

We assessed neuromuscular fatigue and recovery of the plantar flexors after playing football with or without severe heat stress. Neuromuscular characteristics of the plantar flexors were assessed in 17 male players at baseline and ∼30 min, 24, and 48 h after two 90-min football matches in temperate (∼20 °C and 55% rH) and hot (∼43 °C and 20% rH) environments. Measurements included maximal voluntary strength, muscle activation, twitch contractile properties, and rate of torque development and soleus EMG (i.e., root mean square activity) rise from 0 to 30, -50, -100, and -200 ms during maximal isometric contractions for plantar flexors. Voluntary activation and peak twitch torque were equally reduced (-1.5% and -16.5%, respectively; P < 0.05) post-matches relative to baseline in both conditions, the latter persisting for at least 48 h, whereas strength losses (∼5%) were not significant. Absolute explosive force production declined (P < 0.05) 30 ms after contraction onset independently of condition, with no change at any other epochs. Globally, normalized rate of force development and soleus EMG activity rise values remained unchanged. In football, match-induced alterations in maximal and rapid torque production capacities of the plantar flexors are moderate and do not differ after competing in temperate and hot environments.

Assessment of Neuromuscular Function Using Percutaneous Electrical Nerve Stimulation

Percutaneous electrical nerve stimulation is a non-invasive method commonly used to evaluate neuromuscular function from brain to muscle (supra-spinal, spinal and peripheral levels). The present protocol describes how this method can be used to stimulate the posterior tibial nerve that activates plantar flexor muscles. Percutaneous electrical nerve stimulation consists of inducing an electrical stimulus to a motor nerve to evoke a muscular response. Direct (M-wave) and/or indirect (H-reflex) electrophysiological responses can be recorded at rest using surface electromyography. Mechanical (twitch torque) responses can be quantified with a force/torque ergometer. M-wave and twitch torque reflect neuromuscular transmission and excitation-contraction coupling, whereas H-reflex provides an index of spinal excitability. EMG activity and mechanical (superimposed twitch) responses can also be recorded during maximal voluntary contractions to evaluate voluntary activation level. Percutaneous nerve stimulation provides an assessment of neuromuscular function in humans, and is highly beneficial especially for studies evaluating neuromuscular plasticity following acute (fatigue) or chronic (training/detraining) exercise.

Central and peripheral fatigability in boys and men during maximal contraction

PURPOSE

The purpose of this study was to examine central and peripheral factors of fatigability that could explain the differences in fatigability between adults and prepubertal boys after maximal sustained isometric contraction.

METHODS

A total of 11 untrained adult men and 10 prepubescent boys volunteered to participate in this study. The level of voluntary activation was assessed before and after fatigue by means of the twitch interpolation technique as well as peak twitch torque, maximum rate of torque development and maximum M-wave (Mmax) area of the soleus and medial gastrocnemius. The fatigue-inducing protocol consisted of a sustained maximal voluntary contraction (MVC) of the ankle's plantar flexor at 100% of MVC until the task could no longer be sustained at 50% of MVC.

RESULTS

During the fatigue-inducing protocol, boys were fatigued less, showing longer endurance limit and delayed torque and agonist EMG decrease. After fatigue, the level of activation decreased to a similar extent in both groups, and boys were less affected regarding their peak twitch torque and rate of torque development, whereas no differentiation between the groups was observed regarding the decrease in Mmax area of the examined muscles.

CONCLUSIONS

The results obtained provide evidence that the greater fatigability resistance in prepubertal children during sustained maximal contractions is mainly explained by peripheral rather than central factors.

Electromyographic, cerebral, and muscle hemodynamic responses during intermittent, isometric contractions of the biceps brachii at three submaximal intensities

This study examined the electromyographic, cerebral and muscle hemodynamic responses during intermittent isometric contractions of biceps brachii at 20, 40, and 60% of maximal voluntary contraction (MVC). Eleven volunteers completed 2 min of intermittent isometric contractions (12/min) at an elbow angle of 90° interspersed with 3 min rest between intensities in systematic order. Surface electromyography (EMG) was recorded from the right biceps brachii and near infrared spectroscopy (NIRS) was used to simultaneously measure left prefrontal and right biceps brachii oxyhemoglobin (HbO₂), deoxyhemoglobin (HHb), and total hemoglobin (Hb_tot). Transcranial Doppler ultrasound was used to measure middle cerebral artery velocity (MCAv) bilaterally. Finger photoplethysmography was used to record beat-to-beat blood pressure and heart rate. EMG increased with force output from 20 to 60% MVC (P < 0.05). Cerebral HbO₂ and Hb_tot increased while HHb decreased during contractions with differences observed between 60% vs. 40% and 20% MVC (P < 0.05). Muscle HbO₂ decreased while HHb increased during contractions with differences being observed among intensities (P < 0.05). Muscle Hb_tot increased from rest at 20% MVC (P < 0.05), while no further change was observed at 40 and 60% MVC (P > 0.05). MCAv increased from rest to exercise but was not different among intensities (P > 0.05). Force output correlated with the root mean square EMG and changes in muscle HbO₂ (P < 0.05), but not changes in cerebral HbO₂ (P > 0.05) at all three intensities. Force output declined by 8% from the 1st to the 24th contraction only at 60% MVC and was accompanied by systematic increases in RMS, cerebral HbO₂ and Hb_tot with a leveling off in muscle HbO₂ and Hb_tot. These changes were independent of alterations in mean arterial pressure. Since cerebral blood flow and oxygenation were elevated at 60% MVC, we attribute the development of fatigue to reduced muscle oxygen availability rather than impaired central neuronal activation.

The effect of muscle fatigue on stimulus intensity requirements for central and peripheral fatigue quantification

PURPOSE

The present study was designed to determine the stimulation intensity necessary for an adequate assessment of central and peripheral components of neuromuscular fatigue of the knee extensors.

METHODS

Three different stimulation intensities (100, 120 and 150% of the lowest intensity evoking a plateau in M-waves and twitch amplitudes, optimal stimulation intensity, OSI) were used to assess voluntary activation level (VAL) as well as M-wave, twitch and doublet amplitudes before, during and after an incremental isometric exercise performed by 14 (8 men) healthy and physically active volunteers. A visual analog scale was used to evaluate the associated discomfort.

RESULTS

There was no difference (p > 0.05) in VAL between the three intensities before and after exercise. However, we found that stimulating at 100% OSI may overestimate the extent of peripheral fatigue during exercise, whereas 150% OSI stimulations led to greater discomfort associated with doublet stimulations as well as to an increased antagonist co-activation compared to 100% OSI.

CONCLUSION

We recommend using 120% OSI, as it constitutes a good trade-off between discomfort and reliable measurements.